- This single-center study of patients with longstanding Crohn’s disease (CD) and ulcerative colitis (UC) linked guideline-based surveillance to low incidence of colorectal dysplasia (CRD) and colorectal cancer (CRC).
- Chromoendoscopy was underused.
- "Meeting current...surveillance recommendations may result in low CRC rates in all IBD patients.”
- “Surveillance earlier than 8 years in the absence of PSC (primary sclerosing cholangitis) is likely not indicated.”
Why this matters
- Dysplasia in patients with IBD is poorly understood.
- Recent recommendations call for repeat surveillance colonoscopies beginning 6-8 years after disease onset.
- Single-center retrospective cohort study of UC and colonic CD patients with ≥8 years of disease duration or concomitant PSC (n=680).
- Outcomes: adherence to surveillance guidelines; incidence of CRC, dysplasia.
- Funding: McGill CAS Research Support Program; Kimberly Sue McCall Award; Nesbitt-McMaster Award; Pfizer.
- Median disease duration, 17 years.
- UC and colonic CD, respectively:
- Surveillance adherence: 76%, 66% (PSC: 33%).
- Chromoendoscopy: 2.4%, 0%.
- Biopsy adequacy: 54%, 29%.
- Dysplasia detection: 7%, 3%, mostly low-grade dysplasia (LGD); 3 CRC cases found.
- CRC incidence/100,000 patient-years: 19.5, 25.1.
- High-grade dysplasia incidence/100,000 patient-years: 58.5, 37.6.
- Before 8 years of disease duration in UC and CD:
- Dysplasia: 19.5, 12.5/100,000 patient-years (PSC, 0).
- CRC: none.
- Rates not population-based.